Keir P J, Bach J M, Rempel D M
Division of Occupational Medicine, Department of Medicine, University of California, San Francisco, USA.
J Hand Surg Am. 1998 Nov;23(6):1004-9. doi: 10.1016/S0363-5023(98)80007-5.
Persistent elevations in carpal tunnel pressure may aggravate carpal tunnel syndrome. This study examined the effects of finger posture on carpal tunnel pressure during wrist motion. Carpal tunnel hydrostatic pressure was measured using a saline-filled catheter inserted into the nondominant wrists of 14 healthy individuals. Range of motion tasks of wrist flexion-extension and radioulnar deviation were repeated with metacarpophalangeal (MCP) joint angles of 0 degrees, 45 degrees, and 90 degrees flexion. Pressures were significantly greater with the fingers straight (MCP = 0 degrees) than when the MCP joints were flexed to 45 degrees for all radioulnar deviation angles and from 10 degrees of wrist flexion to all angles of wrist extension tested. Pressures were also significantly higher with MCP joints at 0 degrees than at 90 degrees for wrist extension angles from 10 degrees to 40 degrees. Pressures increased to over 30 mm Hg (4.0 kPa) in some wrist extension and ulnar and radially deviated postures. Finger and wrist postures should be considered when designing splints or evaluating tasks for patients with carpal tunnel syndrome.
腕管压力持续升高可能会加重腕管综合征。本研究考察了手指姿势对腕部运动期间腕管压力的影响。通过将充满生理盐水的导管插入14名健康个体的非优势手腕来测量腕管静水压。在掌指（MCP）关节屈曲角度为0度、45度和90度的情况下，重复进行腕部屈伸和桡尺偏斜的运动范围任务。对于所有桡尺偏斜角度以及从腕部屈曲10度到测试的所有腕部伸展角度，手指伸直（MCP = 0度）时的压力明显大于MCP关节屈曲至45度时的压力。对于腕部伸展角度从10度到40度，MCP关节处于0度时的压力也明显高于处于90度时的压力。在某些腕部伸展以及尺侧和桡侧偏斜姿势下，压力会升高到超过30毫米汞柱（4.0千帕）。在为腕管综合征患者设计夹板或评估任务时，应考虑手指和手腕的姿势。
